How should we eat?

Most of us are familiar with Michael Pollan’s advice to “Eat food. Not too much. Mostly plants.”

That’s fine if you don’t have diabetes. But when you do, eating mostly plants may not be the best choice unless you have ethical qualms about eating meat. We need to get protein in our diet, and the plant foods that contain protein (like beans) tend to contain a lot of starch as well, and that makes our blood glucose (BG) go up.

So I was thinking how we could modify this prescription for people with diabetes. I discussed it with fellow Health Central blogger David Mendosa, but you can blame me if you don’t like the final product. It is:

Most people agree that the less a food is processed, the healthier it is. Processing strips away vitamins and minerals, and it also tends to increase the glycemic index, which is a measure of how fast a food will raise your BG levels.

Moderately means the same as “not too much.” The goal is to eat enough so that you’re no longer hungry, but not so much that you’re stuffed. In the long run, eating a little of a variety of foods will offer more pleasure than eating huge quantities of some diet food that you don’t particularly like. Moderately means that you can occasionally have a few bites of some “forbidden food.” For some, that may be better than avoiding it completely, which tends to make people feel deprived until they give in and binge on the forbidden food.

Mindfully means eating slowly and consciously, taking the time to taste the food, feel the textures, and maybe think of how much work other people did to grow and bring you this delicious food. Eating slowly helps because it takes 20 minutes or more for the satiety signals that tell your brain that you’ve had enough to kick in. If you wolf your food down, you’re apt to eat a lot more than you really want.

Fish contains long-chain omega-3 fatty acids, which have been shown to reduce inflammation and heart disease. Eating fish doesn’t mean you should never eat red meat or chicken. If you live near the ocean where a variety of fresh fish is available, you might want to have fresh fish at least several times a week. If you live inland where the only fish you can get is frozen and not very tasty, you can still eat canned sardines. They are actually one of the healthiest fish around, because they contain fewer pesticides than the larger fish. Each animal that eats another animal tends to concentrate the pesticides from the prey animal, so fish on the top of the food chain have the most. Sardines have the least.

Grains are fine if you don’t have diabetes. If you do have diabetes, grains will raise your BG. Whole grains are slightly better than highly processed grains like white flour, but they’ll still make your BG levels go up when you can’t produce much insulin, and you’re best off avoiding them.

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As people with diabetes, we have to focus our attention on a lot of health-related issues. We have to remember to take our drugs. We have to calculate how much of various foods to eat. We have to monitor our blood pressure and lipid levels. All of this is important. But it’s also important to forget about health for a bit, to focus on something else: our friends, our family, the beauty of nature, the sound of good music. Whatever we enjoy, we should focus on for part of every day.

Life, with our without diabetes, can be depressing. It can also be beautiful. Let’s focus on the beautiful for at least part of every day.